scholarly journals Trends in Healthcare Access in Japan during the First Wave of the COVID-19 Pandemic, up to June 2020

2021 ◽  
Vol 18 (6) ◽  
pp. 3271
Author(s):  
Koji Makiyama ◽  
Takayuki Kawashima ◽  
Shuhei Nomura ◽  
Akifumi Eguchi ◽  
Daisuke Yoneoka ◽  
...  
Keyword(s):  
Average Length ◽  
Healthcare Access ◽  
Hospitalized Patients ◽  
Management Support ◽  
Term Care ◽  
Aggregated Data ◽  
Healthcare Facilities ◽  
Hospital Stays ◽  
The Impact

We evaluated the impact of the new coronavirus disease (COVID-19) on healthcare access in Japan in terms of the number of outpatients and hospitalized patients as well as the length of hospital stays, during the first wave of the pandemic, up to June 2020. This observational study evaluated the monthly average number of outpatients per day at hospitals, the average number of hospitalized patients per day, and the average length of hospital stays per patient, from December 2010 to June 2020, using the hospital reports data, which are open aggregated data on the utilization of hospitals from the Ministry of Health, Labour and Welfare. These numbers were compared with those from the same period of previous years, using a quasi-Poisson regression model. We found a nationwide decrease in the number of outpatients in general hospitals and hospitalized patients, particularly in long-term care beds in Japan, as well as the excess length of hospital stays among psychiatric care patients during the first wave of the COVID-19. This limited access to healthcare demonstrated the importance of the long-term health monitoring of vulnerable populations and the need for urgent management support to healthcare facilities in preparation for possible prolonged pandemics in the future.

Pandemic-Driven Disruptions in Oral Health: Transformative Trends in Care for Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 416-416
Author(s):  
Samuel Zwetchkenbaum ◽  
Mary Fisher ◽  
Brooke Fukuoka ◽  
Jeffrey Dodge ◽  
Michael Helgeson ◽  
...  
Keyword(s):  
Oral Health ◽  
Access To Care ◽  
Rhode Island ◽  
Care Delivery ◽  
Healthcare Access ◽  
Oral Care ◽  
Term Care ◽  
Minimally Invasive Dentistry ◽  
The Impact

Abstract Oral healthcare for the aging was severely disrupted during the pandemic of coronavirus disease 2019 (COVID-19). Transformative changes in care delivery involved teledentistry, mobile/portable dentistry, minimally invasive dentistry, aerosol minimization, and interprofessional oral care. Management of chronic oral health problems evolved through periods of limited to no access to daily and professional oral healthcare. Access to care has been influenced by availability of the oral care workforce, variability in long term care policy, and the lack of funding to cover medically necessary services delivered via asynchronous telehealth technologies. Impacts were identified six and twelve months into the pandemic. These will be compared to the state of oral healthcare for the aging 18 months from the start of the pandemic. The impact of vaccination on access to care will be explored. Variability between states (Idaho/Michigan/Minnesota/Rhode Island) will be addressed. Directions of new and needed research opportunities will be discussed.

scholarly journals Coronavirus Disease 2019 (COVID-19) Infections Among Healthcare Workers, Los Angeles County, February–May 2020

2020 ◽  
Author(s):  
Stacy Hartmann ◽  
Zachary Rubin ◽  
Heidi Sato ◽  
Kelsey O Yong ◽  
Dawn Terashita ◽  
...  
Keyword(s):  
Los Angeles ◽  
Healthcare Workers ◽  
Los Angeles County ◽  
Infectious Period ◽  
Risk Of Infection ◽  
Term Care ◽  
Healthcare Facilities ◽  
Patient Interviews ◽  
The Impact

Abstract Across the world, healthcare workers (HCW) are at a greater risk of infection by coronavirus disease 2019 (COVID-19) due to the nature of their work. The Los Angeles County Department of Public Health (LAC DPH) set out to understand the impact of COVID-19 on healthcare facilities and HCWs by tracking and analyzing data from case-patient interviews of HCWs. As of 31 May, over 3 months into the pandemic, nearly 5500 positive HCWs were reported to LAC DPH, representing 9.6% of all cases. Cases reported working in 27 different setting types, including outpatient medical offices, correctional facilities, emergency medical services, and so forth, with the highest proportion from long-term care facilities (46.6%) and hospitals (27.7%). Case patients included both clinical and nonclinical roles, with nearly half (49.4%) of positive HCWs being nurses. Over two-thirds of HCWs (68.6%) worked at some point during their infectious period, and nearly half (47.9%) reported a known exposure to a positive patient and/or coworker within their facility. Overall, compared to all LAC cases, HCWs reported lower rates of hospitalization (5.3% vs 12.2%) and death (0.7% vs 4.3%) from COVID-19. There are many factors that increase HCWs risk of infection, including high-risk work environment, limited supply of personal protective equipment, and even pressure to help and work during a pandemic. In response to these data, LAC DPH created resources and provided guidance for healthcare facilities to best protect their patients and staff during the COVID-19 pandemic.

scholarly journals A Pilot of a Sustainability-Extending Intervention in Canadian Nursing Homes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 540-541
Author(s):  
Lauren MacEachern ◽  
Yuting Song ◽  
Liane Ginsburg ◽  
Adrian Wagg ◽  
Matthias Hoben ◽  
...  
Keyword(s):  
Scale Up ◽  
Qualitative Assessment ◽  
High Dose ◽  
Study Phase ◽  
Management Support ◽  
Term Care ◽  
Implementation Period ◽  
Research Investments ◽  
The Impact

Abstract Understanding of intervention sustainability processes is limited. Failure to sustain evidence-based innovations means that intended improvements are short-lived, scale-up and spread are unlikely, and real losses are incurred on research investments. We explored the sustainability of a health care aide (HCA)-led quality improvement (QI) initiative, Safer Care for Older Persons (in residential) Environments (SCOPE), that was implemented in long-term care homes (LTCHs) in Manitoba, Canada. Based on our understanding of factors influencing post-implementation sustainability processes, we developed and piloted a “low-dose” and “high-dose” “Booster” intervention to extend the two-year post-implementation period over which SCOPE was naturally sustained. Both versions of the “Booster” involved the following components: a HCA-led team with management support, a workshop to review SCOPE QI approaches and tools, a binder of QI resources, and supports from an experienced Quality Advisor (QA). We collected data from various sources to depict the most accurate account of QI sustainability and conducted thematic analysis to understand each team’s experience with sustainability processes. We used a qualitative assessment rubric to evaluate the impact of the “Booster” conditions on the teams’ performance against core SCOPE components. Our results suggest that the “Booster” served to establish more relaxed expectations and generally renew interest in LTCH QI initiatives. The calibre of management support was associated with teams’ performance and management support varied with the level of QA support. These pilot results will inform the next study phase, which examines longer-term sustainability of QI initiatives in LTCHs beyond the initial 2-year post-implementation period.

The impact of ageing on hospital care and long-term care—the example of Germany

Health Policy ◽  
2004 ◽  
Vol 67 (1) ◽  
pp. 57-74 ◽  
Author(s):  
Erika Schulz ◽  
Reiner Leidl ◽  
Hans-Helmut König
Keyword(s):  
Hospital Care ◽  
Long Term Care ◽  
Term Care ◽  
The Impact

scholarly journals Public reporting of performance measures in long-term care in Canada: does it make a difference?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poldrugovac ◽  
J E Amuah ◽  
H Wei-Randall ◽  
P Sidhom ◽  
K Morris ◽  
...  
Keyword(s):  
Performance Measures ◽  
Performance Indicators ◽  
Long Term Care ◽  
Public Reporting ◽  
Policy Implications ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
The Impact

Abstract Background Evidence of the impact of public reporting of healthcare performance on quality improvement is not yet sufficient to draw conclusions with certainty, despite the important policy implications. This study explored the impact of implementing public reporting of performance indicators of long-term care facilities in Canada. The objective was to analyse whether improvements can be observed in performance measures after publication. Methods We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, while the other 8 are privately reported. We analysed data from the Continuing Care Reporting System managed by the Canadian Institute for Health Information and based on information collection with RAI-MDS 2.0 © between the fiscal years 2011 and 2018. A multilevel model was developed to analyse time trends, before and after publication, which started in 2015. The analysis was also stratified by key sample characteristics, such as the facilities' jurisdiction, size, urban or rural location and performance prior to publication. Results Data from 1087 long-term care facilities were included. Among the 8 publicly reported indicators, the trend in the period after publication did not change significantly in 5 cases, improved in 2 cases and worsened in 1 case. Among the 8 privately reported indicators, no change was observed in 7, and worsening in 1 indicator. The stratification of the data suggests that for those indicators that were already improving prior to public reporting, there was either no change in trend or there was a decrease in the rate of improvement after publication. For those indicators that showed a worsening trend prior to public reporting, the contrary was observed. Conclusions Our findings suggest public reporting of performance data can support change. The trends of performance indicators prior to publication appear to have an impact on whether further change will occur after publication. Key messages Public reporting is likely one of the factors affecting change in performance in long-term care facilities. Public reporting of performance measures in long-term care facilities may support improvements in particular in cases where improvement was not observed before publication.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

Evaluating and Motivating Activation in Long Term Care: Lessons From a Pilot Study

2021 ◽  
Vol 10 (1) ◽  
pp. 42-46
Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  
Keyword(s):  
Long Term Care ◽  
Driving Simulator ◽  
Care Home ◽  
Lessons Learned ◽  
Term Care ◽  
Care Facilities ◽  
Technological Intervention ◽  
The Impact ◽  
Research Recommendations

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

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